By:- Dr. Babu S Madarkar, Clinical Director of KIMS Cuddles & Chief Neonatologist, KIMS Cuddles ,KIMS Cuddles, Sec–bad
Childhood malnutrition in India has traditionally been associated with undernutrition and low body weight. But the nature of the problem is changing, with overweight and obesity increasingly emerging as a serious health concern among children, particularly in urban areas.
In Telangana, the prevalence of obesity among children increased from 0.7% in NFHS-4 to 3.4% in NFHS-5. Various studies have also reported combined overweight and obesity rates of 20% to 35% among school-going children in urban Hyderabad.
Dr. Babu S. Madarkar, Clinical Director and Chief Neonatologist, KIMS Cuddles, Secunderabad, said the growing prevalence of childhood obesity required attention not only from parents but also from schools and policymakers.
A double burden of malnutrition
India is facing what health experts describe as a ‘double burden of malnutrition’. While undernutrition, stunting and micronutrient deficiencies continue to affect children in several parts of the country, overweight and obesity are simultaneously increasing.
An estimated 4.1 crore children in India are overweight or obese. The growing consumption of packaged foods high in sugar, salt and fat, refined carbohydrates, chips, noodles and sugary beverages is contributing to unhealthy eating patterns among children.
“Being overweight does not necessarily mean that a child is adequately nourished. Micronutrient deficiencies can coexist with excess body weight,” Dr. Madarkar said.
Telangana witnessing a sharp rise
According to NFHS data, childhood obesity in Telangana increased from 0.7% in 2015-16 to 3.4% in 2019-21, an increase of 2.7 percentage points. Telangana is among the States reporting a relatively high prevalence of childhood obesity. At the same time, overweight and obesity among adults are also significant concerns. An ICMR-NIN study has estimated that 47.7% of adults in Telangana are overweight or obese.
The lifestyle and dietary habits of parents can influence children as well. While some children continue to face anaemia and other micronutrient deficiencies, increasing BMI among adolescents is adding another dimension to the nutritional challenge.
Hyderabad at the centre of the urban obesity problem
Rapid urbanisation, changing lifestyles, increased time spent indoors, online food delivery and easy access to junk food are contributing to the rise in childhood overweight and obesity in Hyderabad.
Studies conducted among schoolchildren, particularly in urban settings, have reported significant levels of overweight and obesity when assessed using IAP growth standards. Some studies have also reported combined prevalence of overweight and obesity of around 19% to 21% in government and semi-urban schools.
This indicates that childhood obesity is no longer a problem confined to children from affluent families.
In rapidly developing neighbourhoods such as Gachibowli, Miyapur and Madhapur, children are spending less time engaging in physical activity. Academic pressure, limited access to playgrounds, increased screen time and a preference for indoor entertainment are contributing to increasingly sedentary lifestyles.
One in two or three children overweight?
Clinical observations from urban Hyderabad suggest that overweight and obesity are increasingly common among school-going children, with some settings reporting one in every two or three children being overweight or obese.
The changing pattern calls for a shift in focus, with childhood obesity receiving the same attention as undernutrition and growth-related disorders.
‘Adult diseases’ appearing at a younger age
Excess body weight during childhood can increase the risk of health problems such as hypertension, fatty liver disease and type-2 diabetes.
Conditions that were once largely associated with adulthood are now being identified among younger age groups, making early prevention particularly important.
Prolonged use of mobile phones, television and other screens is reducing the time children spend in physical activity. Screen-based eating is another concern, with children increasingly consuming chips, noodles, biscuits and sugary drinks while watching television or using mobile devices.
This combination can lead to excessive calorie intake and interfere with normal appetite regulation.
Weight reduction alone is not the answer
Managing childhood obesity should not be reduced to simply asking a child to eat less or lose weight, Dr. Madarkar said.
A comprehensive approach should include healthy eating habits, adequate physical activity, responsible screen use, mental well-being and changes in family lifestyle.
“Parents need to lead by example rather than simply instructing children to follow a healthy lifestyle. Families should adopt healthier eating habits and make physical activity a part of everyday life,” he said. Schools, too, have an important role to play by providing adequate time for sports, exercise and other forms of physical activity.
Need to regulate packaged foods
The easy availability and aggressive marketing of foods high in sugar, salt and fat are also contributing to unhealthy dietary choices among children.
The ‘Let’s Fix Our Food’ initiative led by ICMR-NIN has made several recommendations aimed at improving the food environment for young people, including the need for clearer front-of-pack nutrition labelling to help consumers identify foods high in sugar, salt and fat.
Curb junk food around schools
There are regulations concerning the sale and advertisement of foods high in fat, sugar and salt in and around school premises. However, experts say stronger monitoring and effective implementation are needed. Schools should adopt the ‘Eat Right School’ approach, ensure that canteens comply with necessary food safety requirements, periodically review food menus and seek guidance from nutrition experts.
At least an hour of physical activity a day
Schools should ensure that children remain physically active for at least 45 to 60 minutes every day through exercise, sports or other age-appropriate activities.
This should apply to both government and private schools. Urban planning must also take children’s needs into account by providing safe playgrounds, walking paths and cycling tracks.
As residential areas expand rapidly, protecting open spaces where children can play and remain physically active is equally important.
Childhood obesity, therefore, needs to be viewed not merely as an individual or family issue but as a growing public health challenge requiring coordinated action by parents, schools, communities and policymakers.